Plans for a new hospital for Carlisle, Cumbria, have been cancelled five times in the last 20 years.

Now the city has a new high-tech hospital - but since it opened in April 2000, the £87m hospital has encountered a series of problems, which its advocates call "teething problems" and its detractors a "catalogue of errors".

Independent onlookers say the hospital, the first to be built under the controversial private finance initiative, has had significant problems.

The government is committed to using the private sector to modernise the health service.

But the experience of the first hospital to be built and run by the private sector suggests that it will not have an easy ride extending the policy more widely.

Why didn't they take the facilities they had, then better them?

Linda Weightman, Unison

Despite opening on budget and ahead of schedule, the Cumberland Infirmary has faced significant problems.

The hospital has been plagued by reports of blocked sewerage pipes which spewed out waste into sinks, flooding in the maternity unit, overheating in the atrium and of a patient injured after falling in the hospital's revolving door.

Many patients have complained about the atrium - a centrepiece of the hospital. On one occasion, temperatures reached 110 degrees Fahrenheit in the hospital.

You've got to look at what we had - a tower block built in the 60s that nobody wanted to refurbish, a hospital that used to be the workhouse, a maternity unit that was very old and which didn't have consultants on site

Eric Martlew, MP for Carlisle

And in May, there was a power failure, during which nurses had to manually ventilate some patients.

There were also basic design faults, such as disabled services being placed at the back of the hospital away from the car park. A new one has been built, but the door to the unit is not suitable for disabled people to use.

Private responsibility

Under the PFI scheme, the private company which built the hospital, Health Management Carlisle plc, has to fix the problems.

The NHS has to pay an annual fee of £12.3m, which also covers services such as catering and cleaning.

Robin MacLeod, chief executive of North Cumbria Health Authority (NCHA) said of the new hospital: "You're always going to get problems with a new hospital. I don't think they're linked to the PFI as such.

"There have been some teething problems, but I don't think there's anything that's unable to be fixed.

He added: "I think it's very easy to highlight some issues and make them appear to be worse than they are."

Not unique

Brian Earley, acting chief executive of the trust said: "It is generally felt that, for a scheme of this value and complexity, the incidents that have occurred are not unusual nor unique to this contract.

"I am not trying to underplay the problems, but we are working to resolve them, and we will resolve them."

Staff are reported as being demoralised, and this month consultants spoke out in a local paper, calling for an extra 50 beds to be added to the hospital

Consolidation

There used to be three hospitals in Carlisle - the City General, City Maternity and the Cumberland Infirmary.

Eric Martlew, Labour MP for Carlisle said: "You've got to look at what we had - a tower block built in the 60s that nobody wanted to refurbish, a hospital that used to be the workhouse, a maternity unit that was very old and which didn't have consultants on site."

He added that a report in the 1990s showed babies were dying because of the split site, because it was taking doctors too long to get from one site to another.

Then the government agreed Carlisle should be one of the first wave of PFIs.

Mr Martlew said: "In an ideal world, it would have been built with public money, but it had never been built in 20 years.

"Then it was built, and we've got a new building and a totally newly equipped hospital. That's good."

Too few beds

Critics of PFI argue new hospitals always result in fewer beds - and say the same argument is happening over the Carlisle scheme.

An independent report, commissioned by NCHA and Cumbria County Council, published in July this year, said there were enough beds at the infirmary, but added serious bed-blocking was a real possibility if improvements were not made in the way patients were treated and discharged.

The report estimated the number across north Cumbria had fallen from 834 to 729 - a drop of 105.

Unison estimate a reduction of 90, comparing the three old Carlisle hospitals with the new PFI scheme.

The trust itself says there are just 10 less beds - 442, compared to 452.

'Demoralised staff'

Union representatives say staff at the hospital are demoralised. Employees of the private facilities providers Interserve have even recently agreed to ballot for strike action.

Linda Weightman, Unison convenor at the hospital, said: "There have been a catalogue of errors. And there are a lot of things they can't do anything about - such as the lack of space -and there's no space to store anything in medical records and x-ray."

Calling the new hospital a "white elephant", she added; "Why didn't they take the facilities they had, then better them?"

With the government committed to extending the scope of the private sector in the NHS, there is likely to be even more controversy in the hospital sector in the future.